Lecretia's Choice

by Matt Vickers

  I did not have the same boundless compulsion to be a father—I did not want a child at any cost. But when I focused on Lecretia’s desire to be a mother, and what having a child would mean to her, I gave my consent. I had my love for her, and that was what I drew upon. I wanted more than anything for her to be a mother, because that was what she wanted, and she deserved it more than anyone.

  Meanwhile she’d been to see her GP, and got a referral for a neurology appointment in a few months’ time. She pushed for something earlier but there was nothing available. She was still taking migraine medication. While Lecretia endured her headaches, we looked at possible donors, and settled on a young woman we both liked. We weren’t given many details, but knew that she came from a family of Iraqi refugees, and something about her in her photos reminded us of Lecretia.

  As we organised San Diego, Lecretia became more and more excited. She believed that her eggs were the fundamental problem. Now we had a donor she was filled with hope.

  One morning, walking to work, taking the same route through the botanical gardens that she always took, Lecretia called me. ‘Matt, they’ve moved the lamppost.’

  ‘What do you mean?’

  ‘It’s not where it was. They’ve moved it over to another part of the garden and put it in a stupid place.’

  ‘That’s a shame,’ I said. ‘They must have had a reason.’

  ‘It doesn’t make any sense where it is now.’

  ‘Things change, I guess.’

  ‘I don’t like it,’ she said. ‘It’s not the same any more. Why do things have to change?’

  Chapter 10

  LECRETIA’S GP CALLED in February 2011 to tell us that she’d managed to secure an earlier neurology appointment. We agreed to go to the appointment before booking our flights to San Diego.

  In the last two months Lecretia’s headaches had worsened. She described her vision as ‘crazy’ but had trouble describing it in any further detail.

  Lecretia was nervous about the appointment, and so was I. Neither of us dared to utter what we feared the most. We met with Dr David Abernethy, a respected neurologist, late on a Monday afternoon at his office at Wakefield Hospital in Newtown. It was in a large examining room a few floors up in a building that was dim and quiet with dark-stained wooden interiors. Dr Abernethy was a stern man, but I felt I was in the presence of someone who knew his field and was trustworthy.

  Dr Abernethy began to examine Lecretia. He checked her sight, her perception of colour, sound and movement, and her reflexes. He performed basic tests: squeeze my hands, lift your right arm and now your left. He held up his finger and moved it around Lecretia’s field of vision, mapping out its extremities. Something was wrong. Lecretia could not see anything on the left-hand side of her body.

  If you look straight ahead and imagine everything left of your nose missing from your field of view, that was Lecretia’s experience. But she hadn’t realised it. Her brain was tricking her into thinking she was seeing a full picture.

  That something so glaringly wrong had escaped my notice was crushing. How could such a fundamental problem not be obvious? How had I missed it?

  Dr Abernethy scheduled urgent scans for the next day. He expected some sort of abnormality. He told us that much. We left his office in shock.

  I rang Shirley: ‘We saw the neurologist. Something’s wrong and we’re not sure what. Lecretia’s getting scans tomorrow. You’d better get down here.’

  Did we sleep that night? I don’t remember. Did we cry? We must have. Lecretia had her MRI the next day at 2 pm. I was invited into the room but had to stay behind a curtain. I could not see what was going on, but I could listen. All I could hear was the clank and whirr of a mysterious machine. I wondered what the radiologists were seeing. Something was wrong with my wife.

  Dr Abernethy told us afterwards we should see him at Wellington Hospital first thing the next morning. He told us that there was something on the scan and that we needed to see it.

  We arrived early. The suspense of the situation affected us in different ways. Lecretia was quiet and calm, as though numb. I was full of adrenalin and felt like the smallest thing could send me into a panic. The receptionist told us Dr Abernethy hadn’t arrived yet. She answered us in a weary but firm voice. We sat and waited. Some other people had brought along books. I wondered what they were here for. There was music—Peter Cetera was singing ‘If You Leave Me Now’. I held Lecretia’s hand and she rested her head on my shoulder. My other hand drummed incessantly on the arm of the chair beside me. My mind was racing. We didn’t speak.

  We saw Dr Abernethy arrive and walk through the reception area, pulling a wheeled suitcase behind him. He was twenty minutes late. If he saw us he didn’t acknowledge us. He disappeared somewhere behind reception.

  As we waited, I listened to the receptionists arguing about how to restructure his appointments to adjust for the late start. ‘Don’t move Imogen,’ one of them said. ‘She’s the really sick one.’

  Dr Abernethy appeared and called Lecretia’s name. He took us to a small room off the main corridor and offered us both a seat.

  He told us he hadn’t actually seen the scans yet, but that he had been informed there was something on them. As he loaded them onto the computer he warned us that whatever we saw might be subtle. The first few images showed nothing. But then a white shape appeared, and swelled like burnt celluloid until we came to rest on an image of the entire thing—a fat white mass that covered a quarter of her brain, and pushed hard against the brain’s centre.

  It was not subtle. Lecretia didn’t want to look at it, and I couldn’t blame her.

  If she’d complained earlier, a little more, a little harder, we might have taken her to the emergency department. They might have noticed something when examining her, booked a scan, and we would have been looking at something less grotesque. In this room, she and I realised that her stoicism might have cost us her life, and that it was her insistence on seeing a neurologist urgently that might now have saved it.

  ‘Okay,’ said Dr Abernethy. ‘This is very serious.’

  ‘What is it?’ I said.

  ‘Until we take a biopsy we won’t know for sure. But it is almost certainly a glioma.’

  ‘Cancer?’

  ‘Yes. I’m sorry.’

  As he looked at the scans again, I put my arm around Lecretia and squeezed her shoulder. She absorbed the news in silence. There was a strange dissonance in having my arm around this woman and at the same time seeing the contents of her skull displayed in slices on a black-and-white screen.

  ‘I’m going to book you in to see a neurosurgeon tomorrow. I’m almost certain he’ll have to operate. If you look at this scan, you can see how the left side of the brain is causing something called midline shift, and it’s compressing the brain stem.’

  I could see what he meant. One half of the brain dwarfed the other, and the midline had bulged out towards the other hemisphere, squashing the central cavity.

  I started asking Dr Abernethy questions, and he answered as best he could. ‘The neurosurgeon will be able to tell you more,’ he said finally. ‘Take some time to process this news. I suspect you’ll be dealing with this situation for a while: this is just the beginning. You’ll have plenty of time for questions.’

  We left. Lecretia remained silent.

  ‘Do you want to get a coffee?’ I asked uselessly. She didn’t drink coffee.

  ‘I just want to go home.’

  Once we were in the car and driving she let herself go. As I turned out of the hospital we both started to cry. I wiped my eyes and drove on. I probably shouldn’t have been driving. But my girl wanted to go home, and I wanted to do whatever she wanted. I couldn’t fathom the impact it must have had on her. We were so close to going to San Diego. So close to starting our family. We knew that everything had changed and the future that we thought we had together was now nothing more than a distant fantasy.

  This woman, who had given me so much, shown me so m
uch love, needed me now more than ever. I resolved, on that journey home, to do everything I could to help her.

  Once I’d got Lecretia home, Shirley arrived from Tauranga, and she took her daughter in her arms and they both burst into tears.

  ‘I’m sorry, Mum,’ Lecretia said, as though she were somehow to blame. ‘I’m not going to be able to look after you like I promised.’

  I decided I should talk to my boss and sent him a quick note, asking to see him to discuss something personal. He agreed to meet, and I went into the office to explain. He told me to go home and not to worry about work.

  We received a call later that morning from a neurosurgeon, Kelvin Woon, who made an appointment to see us that night. We drove back to the hospital for the second time.

  Kelvin was younger than either of us. He was personable, but his voice had a sense of urgency.

  ‘Lecretia,’ he said. ‘On the scans it looks very much like a glioma, which is a form of brain tumour. Until we operate, we won’t know for certain. There are many different types of brain tumour.’

  The news was hard to comprehend. Was she dying or not? How much time did we have? Kelvin pulled up the scans.

  ‘Do you see here how the mass of the tumour is pressing on the centre line of the brain? That’s a big problem. If we don’t treat the tumour, it will cut off circulation of fluids around the brain stem, which regulates your body’s vital functions—your muscles, your breathing, your nervous system. If we do nothing, you will probably enter a coma from which you will not wake up.’

  ‘How long until that happens?’ asked Lecretia.

  ‘It’s hard to say, but based on the size of the tumour and the way it appears to be growing, it could be within weeks.’

  How was it possible that my wife, walking around, talking, doing her job and laughing and smiling, could end up in a coma within weeks? Could things really move that quickly? The room felt cold.

  ‘So what do we do?’ I asked.

  ‘We need to operate. We will cut open Lecretia’s skull, and where it’s safe to do so, I will remove the tumour. Whatever we remove will be submitted for biopsy, so we know how best to treat the tumour after that. We’ll find out what grade the tumour is. To me it looks like an astrocytoma, which tends to be a lower-grade tumour and which may respond very well to additional treatments.’

  ‘What does grade mean?’

  ‘Tumours are graded from one to four. Grade one tumours are very slow growing. Grade four is the most aggressive. If it’s grade one, you might have decades of life left. If it’s grade four, then you might only have a few years, if that. But, like I said, it doesn’t look like a grade four tumour. We’ll find out with the biopsy.’

  ‘Is it risky?’ Lecretia asked.

  ‘Yes. There is very small chance that you might not survive the surgery. And of course we are dealing with the brain, and we are removing some parts of the brain that are very important. The tumour is located near your occipital, temporal and parietal lobes. I’ve reviewed your notes about your vision problems, and your issues with short-term memory and navigation, so we know those things are already affected by the tumour. After surgery those symptoms are likely to become permanent. Also, the surgery could make you blind, or you could lose your sense of smell, or the ability to speak, or it could affect your memory, or it could do all of those things.’

  It was an awful dilemma: risk a coma or even death, or risk the loss of things that made Lecretia who she was. Would she taste food again? Would she be able to see her family and friends? Would she recognise me, be able to talk to me? What if she came out of surgery and didn’t know who I was?

  ‘I’ll take as few risks as possible,’ Kelvin said. ‘I’ll remove as much of the tumour as I can, safely, and I think I’ll be able to remove enough to reduce the pressure on the brain stem. But looking at the scan, it’s very unlikely that I’ll be able to remove it all. You’ll almost certainly need further treatment afterwards.’

  ‘Like what?’ I asked.

  ‘Radiotherapy, chemotherapy. But first of all we need to operate to remove the immediate danger.’

  ‘I need time to think about it,’ said Lecretia.

  I was incredulous. ‘What’s to think about? You’ll have the surgery, right?’ I said.

  ‘I just want to think it over and make sure I’m sure.’

  ‘That’s okay,’ said Kelvin. ‘Here’s my number. Call me when you know what you want to do.’

  That in itself was an indication of how serious things were. How bad do things need to be before a neurosurgeon will offer you his mobile number?

  ‘Look,’ said Kelvin. ‘You need to stay positive and stay hopeful. There’s an excellent chance that the surgery will be successful and that with treatment you’ll have many more years of quality life. But we need to move quickly.’

  We left the consulting room. Kelvin shook my hand as I left and I felt his compassion. I walked with Lecretia back to the car.

  ‘How did we get here?’ I asked on the drive home.

  Lecretia didn’t respond. She stared straight ahead, tears glistening on her cheeks. I cried too. Every visit to a doctor brought fresh tears. New revelations about Lecretia’s condition and its consequences were being heaped upon us faster than we could deal with them.

  At home, Lecretia changed into her pyjamas, her dressing gown, and her ugg boots. She sat on the bed and stared out the window, and cried in a way I’d never seen before. It was a lament. Until that day she had still been hopeful about San Diego, and starting a family, but now we would need to cancel those plans, almost certainly forever. I held her and didn’t say a word. What was there to say?

  After a while I let her go. I took her hands and held them. ‘Whatever happens, I’m going to be right beside you, babe. I’ll hold your hand through all of this. I’ll take care of you, I promise.’

  ‘I don’t want to lose my sight. I don’t want to not know who you are. I don’t want any of that.’

  ‘That probably won’t happen. It won’t happen. You’re healthy and strong: there’s no reason it won’t go well.’

  ‘You don’t know that.’

  ‘We have to think positive, babe. We have to. Are you seriously considering not having surgery?’

  ‘I don’t want to hold you back. I don’t want you to have to look after me. Maybe it would be easier for everyone if I didn’t have surgery.’

  ‘Are you kidding? You have to do this. I’ll look after you. If I don’t do a good job, I’m sure your mother will help. I don’t want to lose you. Lecretia, you’re everything to me. I need you.’

  Lecretia was clearly working through what all this might mean for others, and hadn’t even started thinking about what it might mean for her. Her selflessness in this situation was a flaw. It was also a quintessentially Kiwi attitude: what would cause the least fuss, the least bother for everyone?

  Like me, Shirley couldn’t believe that Lecretia would even consider not having the surgery.

  ‘Whatever happens, I’ll look after you, Lecretia. Matt and I will be here for you.’

  ‘You have work, Mum. I don’t want you looking after me for years and years. Dad needs you.’

  ‘If you need me, I’ll look after you. You’re my girl. You and Jeremy and Kat are the most important things in my life.’

  ‘I don’t want to make this difficult for anyone.’

  Lecretia’s instinctive kindness and consideration for others were overriding her instinct for self-preservation. But she was also afraid of what might happen to her. Her identity was bound up in her wellness and wholeness. Perhaps she already sensed she would have to reappraise who she was, and wasn’t sure she could do it, or that she wanted to do it.

  ‘You have to have the surgery,’ I said. ‘I need you, and your family needs you. You’re too important to us.’

  I’m not sure whether Lecretia was really entertaining the idea of not going ahead with her surgery, but framing it as something that we needed and wanted her to do
seemed to help her accept that seeking surgery wasn’t selfish, and that she could feel okay about doing it, and finally she agreed.

  I called the neurosurgeon. ‘Lecretia wants to have the surgery.’

  ‘Good,’ he said. ‘It’s the right decision. I’ve scheduled it for Wednesday next week. Lecretia should come to the neurological ward on Tuesday afternoon. We’ll go from there.’

  I talked to Lecretia about telling people and she agreed that we should. I emailed our friends with the news, and told them to come and visit Lecretia if they wanted to. It seemed important, since there was a risk she wouldn’t survive the surgery.

  The news people were expecting to hear was that we’d finally got pregnant, but this was entirely different. No one saw it coming or was quite sure how to take it. The most affected were Lecretia’s family and the girls she’d grown up with.

  To her family, she was the shining light. Her successes and kindness and beauty were a source of strength for everyone. To her friends, she was the gorgeous, glamorous one, the girl whose smile asserted itself in every photograph, whose humility and heart chased out all jealousy.

  People started arriving in Wellington to see her. Lecretia seemed strengthened by these visits, which reminded her that she had so much to live for, and that so many people cared about her. Couriers knocked on our door, bearing gifts sent from London, Washington and Dubai. Our visitors crowded in and sat on the floor, or out on our deck in the lingering summer sun. Lecretia laughed and smiled, and was delighted to see people, particularly those who had travelled great distances.

  I became obsessed with photographing Lecretia—I sensed that after surgery, if she survived, and the ensuing radiotherapy, she would be changed, and I wanted as many images of her as I could get. We went up to the botanical gardens, near the top of Wellington’s cable car, and I took dozens of photographs with the green and blue harbour and city behind her.

  In truth, though, the photos taken over that weekend are not my favourites. She smiled and laughed and posed by herself and with her family, but the unmistakable tightness in her eyes and smile betrayed her private panic and pain. She was grateful for the love that was heaped upon her that weekend, but in moments alone with me she reached for me and let me take her in my arms and she wept.